Pub Date : 2020-01-01DOI: 10.35248/2329-6925.20.8.386
Hai Vu-Minh, Hoang Nang-Trong, S. Duong-Quy
Aneurism is a stretch, convexity and sacs in artery which is caused by abnormally congenital connective tissue, infection, arterial inflammation or artery wall trauma. True brachial artery aneurysm is relatively rare. There are only some cases that have been reported previously in medical literature. Brachial artery aneurysm might be asymptomatic or revealed by a brachial mass with beating pulse or peripheral ischemia. The diagnosis usually relies on ultrasound and arterial scan or magnetic resonance imaging (MRI). The main treatment is the surgery which allows cutting the aneurysm and grafted with a part of great saphenous vein by two end-to-end anastomoses. We present a case report of true aneurysm of brachial artery in a 40 years old woman who was treated in Thai Binh Medical University Hospital.
{"title":"True Brachial Artery Aneurysm in Non-smoker Woman","authors":"Hai Vu-Minh, Hoang Nang-Trong, S. Duong-Quy","doi":"10.35248/2329-6925.20.8.386","DOIUrl":"https://doi.org/10.35248/2329-6925.20.8.386","url":null,"abstract":"Aneurism is a stretch, convexity and sacs in artery which is caused by abnormally congenital connective tissue, infection, arterial inflammation or artery wall trauma. True brachial artery aneurysm is relatively rare. There are only some cases that have been reported previously in medical literature. Brachial artery aneurysm might be asymptomatic or revealed by a brachial mass with beating pulse or peripheral ischemia. The diagnosis usually relies on ultrasound and arterial scan or magnetic resonance imaging (MRI). The main treatment is the surgery which allows cutting the aneurysm and grafted with a part of great saphenous vein by two end-to-end anastomoses. We present a case report of true aneurysm of brachial artery in a 40 years old woman who was treated in Thai Binh Medical University Hospital.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88050217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2329-6925.20.8.392
D. Young, Liana Tatarian, G. Mujtaba, Priscilla T Chow, S. Ibrahim, G. Joshi, Haaris Naji, Phillip Berges, Krishna Akella, H. Sklarek, K. Hussain, A. Chendrasekhar
Background: The rapid outbreak of COVID-19 has necessitated expedient methods of detection to prevent further spread and mortality from the virus. Currently, RT-PCR is considered the gold standard. However, its diagnostic priority compared to Chest CT remains unknown. Objective: We sought to perform a meta-analysis using retrospective studies comparing Chest CT and RT-PCR in COVID-19 detection among hospitalized patients. Methods: We performed a comprehensive literature search using Pubmed and Google Scholar for studies comparing Chest CT and RT-PCR between January 1 and April 3, 2020. Outcomes included COVID-19 detection using RT-PCR alone, Chest CT alone, true positives when combining the two, and true negatives when combining the two. Results were reported as an odds ratio (OR) with 95% CI. Results: A total of 6 retrospective studies were included comparing RT-PCR with Chest CT. A total of 1,400 patients were enrolled (average age 46.28 ± 2.7 years, 41.6% were males). Chest CT was superior to RT-PCR for COVID-19 detection [OR 3.86, 95% CI (1.79- 8.31, p=0.0006)]. Heterogeneity (I2) was high (75%), but sensitivity analysis failed to reveal any single contributor to observed heterogeneity. Conclusion: Chest CT appears to be a more sensitive and quicker alternative to RT-PCR in the detection of COVID-19 in hospitalized patients, and may serve as a superior screening tool.
{"title":"Chest CT versus RT-PCR for Diagnostic Accuracy of COVID-19 Detection: A Meta-Analysis","authors":"D. Young, Liana Tatarian, G. Mujtaba, Priscilla T Chow, S. Ibrahim, G. Joshi, Haaris Naji, Phillip Berges, Krishna Akella, H. Sklarek, K. Hussain, A. Chendrasekhar","doi":"10.35248/2329-6925.20.8.392","DOIUrl":"https://doi.org/10.35248/2329-6925.20.8.392","url":null,"abstract":"Background: The rapid outbreak of COVID-19 has necessitated expedient methods of detection to prevent further spread and mortality from the virus. Currently, RT-PCR is considered the gold standard. However, its diagnostic priority compared to Chest CT remains unknown. Objective: We sought to perform a meta-analysis using retrospective studies comparing Chest CT and RT-PCR in COVID-19 detection among hospitalized patients. Methods: We performed a comprehensive literature search using Pubmed and Google Scholar for studies comparing Chest CT and RT-PCR between January 1 and April 3, 2020. Outcomes included COVID-19 detection using RT-PCR alone, Chest CT alone, true positives when combining the two, and true negatives when combining the two. Results were reported as an odds ratio (OR) with 95% CI. Results: A total of 6 retrospective studies were included comparing RT-PCR with Chest CT. A total of 1,400 patients were enrolled (average age 46.28 ± 2.7 years, 41.6% were males). Chest CT was superior to RT-PCR for COVID-19 detection [OR 3.86, 95% CI (1.79- 8.31, p=0.0006)]. Heterogeneity (I2) was high (75%), but sensitivity analysis failed to reveal any single contributor to observed heterogeneity. Conclusion: Chest CT appears to be a more sensitive and quicker alternative to RT-PCR in the detection of COVID-19 in hospitalized patients, and may serve as a superior screening tool.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89917328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2329-6925.20.8.389
J. Rodríguez-Padilla, C. V. Casariego, T. C. Mirón, J. García
Infrainguinal revascularization in end-stage renal disease patients is controversial, despite of patency and limb salvage rates observed in several studies. This study provides more favourable overall survival and amputation free-survival rates than the contemporary study of the same characteristics. The revascularization of patients with ESRD is frequently conditioned by poor survival. With the data we provide, approximately half of the patients were alived and their limb was salvaged at 3 years, and this is encouraging. Thus, we can be more aggressive in daily practice and offer revascularization in ESRD patients. Objective: This study analyzed long-term outcomes and evaluate the benefits and limits of infrainguinal revascularization (IR) both surgical and endovascular revascularization with critical limb ischemia (CLI) in patients with and without ESRD. Material and Methods: A total of 1188 patients were prospectively collected and analyzed retrospectively. We included 108 (9.1%) patients with ESRD and of them 70 (64.8%) receiving hemodialysis. Results: The 30-day mortality rate was higher in ESRD group (5.6 vs. 1.8, p=0,009). The second patency was similar in both groups at 1 and 3 years (87.6% and 85.3% vs. 82.9% and 81.6%). ESRD patients had a lower overall survival and amputation free-survival (AFS) (at 1 year 79.6% vs. 91.8% and at 3 years 57.9% vs. 79.1%, p<0.001) and (at 1 year 68.2% vs. 78.8% and at 3 years 45.7% vs. 64.6%, p<0,001) than non- ESRD patients. The limb salvage rates achieved excellent outcomes during follow-up at 1 and 3 years. (83.5% and 83.2% vs. 66.0% and 77.6% (p=0.194). Cox regression analysis showed that hemodialysis was an independent predictor of all-cause mortality and AFS (HR=2.38, 95% CI 1.54- 3.68, p<0,001). Octogenarian patients and coronary disease was independent predictor of all-cause mortality (HR=3.05, 95% CI 2.3-4.01, p<0.001) and (HR=1.49, 95% CI 1.14-1.95, p=0.03). Conclusions: The long-term patency and limb salvage rates in patients who underwent IR with CLI and ESRD was comparable with non- ESRD patients. Despite, the overall survival and amputation free-survival rates was poorer in ESRD patients, we advocated for aggressive revascularization attitude in ESRD patients but we must individualize treatment decision and should be offered revascularization for patients with acceptable life expectancy.
腹股沟下血运重建术在终末期肾病患者中是有争议的，尽管在一些研究中观察到通畅和肢体保留率。该研究提供了比相同特征的当代研究更有利的总生存率和无截肢生存率。终末期肾病患者的血运重建术常常以生存不良为条件。根据我们提供的数据，大约有一半的患者存活，他们的肢体在3年后被挽救，这是令人鼓舞的。因此，我们可以在日常实践中更积极地为ESRD患者提供血运重建术。目的:本研究分析了伴有和不伴有严重肢体缺血(CLI)的ESRD患者腹股沟下血运重建术(IR)和血管内血运重建术(IR)的长期结果，并评估了其益处和局限性。材料与方法:前瞻性收集1188例患者并进行回顾性分析。我们纳入了108例(9.1%)ESRD患者，其中70例(64.8%)接受了血液透析。结果:ESRD组30天死亡率更高(5.6 vs 1.8, p= 0.009)。两组在1年和3年的第二次通畅度相似(87.6%和85.3% vs. 82.9%和81.6%)。ESRD患者的总生存率和无截肢生存率(AFS)低于非ESRD患者(1年为79.6% vs. 91.8%， 3年为57.9% vs. 79.1%， p<0.001)和(1年为68.2% vs. 78.8%， 3年为45.7% vs. 64.6%， p<0.001)。在1年和3年的随访中，肢体保留率达到了很好的效果。(83.5%和83.2% vs. 66.0%和77.6% (p=0.194)。Cox回归分析显示，血液透析是全因死亡率和AFS的独立预测因子(HR=2.38, 95% CI 1.54- 3.68, p< 0.001)。老年患者和冠心病是全因死亡率的独立预测因子(HR=3.05, 95% CI 2.3-4.01, p<0.001)和(HR=1.49, 95% CI 1.14-1.95, p=0.03)。结论:行IR合并CLI和ESRD患者的长期通畅率和肢体保留率与非ESRD患者相当。尽管ESRD患者的总生存率和无截肢生存率较差，但我们主张对ESRD患者采取积极的血运重建术态度，但我们必须个性化治疗决策，对于预期寿命可接受的患者应给予血运重建术。
{"title":"Long-Term Outcomes after Infrainguinal Revascularization in Patients with Critical Limb Ischemia on End-Stage Renal Disease Patients (ESRD) and Comparison Results with Non-ESRD Population","authors":"J. Rodríguez-Padilla, C. V. Casariego, T. C. Mirón, J. García","doi":"10.35248/2329-6925.20.8.389","DOIUrl":"https://doi.org/10.35248/2329-6925.20.8.389","url":null,"abstract":"Infrainguinal revascularization in end-stage renal disease patients is controversial, despite of patency and limb salvage rates observed in several studies. This study provides more favourable overall survival and amputation free-survival rates than the contemporary study of the same characteristics. The revascularization of patients with ESRD is frequently conditioned by poor survival. With the data we provide, approximately half of the patients were alived and their limb was salvaged at 3 years, and this is encouraging. Thus, we can be more aggressive in daily practice and offer revascularization in ESRD patients. Objective: This study analyzed long-term outcomes and evaluate the benefits and limits of infrainguinal revascularization (IR) both surgical and endovascular revascularization with critical limb ischemia (CLI) in patients with and without ESRD. Material and Methods: A total of 1188 patients were prospectively collected and analyzed retrospectively. We included 108 (9.1%) patients with ESRD and of them 70 (64.8%) receiving hemodialysis. Results: The 30-day mortality rate was higher in ESRD group (5.6 vs. 1.8, p=0,009). The second patency was similar in both groups at 1 and 3 years (87.6% and 85.3% vs. 82.9% and 81.6%). ESRD patients had a lower overall survival and amputation free-survival (AFS) (at 1 year 79.6% vs. 91.8% and at 3 years 57.9% vs. 79.1%, p<0.001) and (at 1 year 68.2% vs. 78.8% and at 3 years 45.7% vs. 64.6%, p<0,001) than non- ESRD patients. The limb salvage rates achieved excellent outcomes during follow-up at 1 and 3 years. (83.5% and 83.2% vs. 66.0% and 77.6% (p=0.194). Cox regression analysis showed that hemodialysis was an independent predictor of all-cause mortality and AFS (HR=2.38, 95% CI 1.54- 3.68, p<0,001). Octogenarian patients and coronary disease was independent predictor of all-cause mortality (HR=3.05, 95% CI 2.3-4.01, p<0.001) and (HR=1.49, 95% CI 1.14-1.95, p=0.03). Conclusions: The long-term patency and limb salvage rates in patients who underwent IR with CLI and ESRD was comparable with non- ESRD patients. Despite, the overall survival and amputation free-survival rates was poorer in ESRD patients, we advocated for aggressive revascularization attitude in ESRD patients but we must individualize treatment decision and should be offered revascularization for patients with acceptable life expectancy.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75242104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sutureless Viabahn anastomosis has been used as a promising technique in selected cases. The current study conducted a sutureless femoropopliteal bypass, through percutaneous accesses and an extra-anatomical trajectory, in a patient with critical limb ischemia. This technique, which is minimally invasive, has become a femoropopliteal revascularization alternative to be applied to high-risk patients with extensive occlusions.
Pub Date : 2020-01-01DOI: 10.35248/2329-6925.20.8.394
Altnji Sam, J. Fayade, B. Bou-Said
The migration of the stent graft is one of the main complications of Endovascular aneurysm repair (EVAR). It is closely related to ineffective contact between the endograft ends and the wall of the blood vessel. In this study, we have developed a realistic stent-graft deployment simulation using the Finite Element Method of 3D nitinol stent in a patient-specific Thoracic Aortic Aneurysm (TAA). This work aims to investigate the impact of the realistic complete stenting procedure by a progressive expanding deployment of the stent graft on the migration behaviour. A comparison of results is investigated between the realistic and non-realistic deployment methods to predict the overall (stent–aorta) biomechanical behaviour. We have also investigated the effect of including the graft material on the mechanical behaviour of the (stent-graft) during the deployment and the contact stability (stentgraft)/aorta after the deployment. The simulation results show that the realistic deployment method did indeed influence the mechanical behaviour, positioning, and eventually the functioning of the stent-graft when compared with the traditional deployment methods. The impact of adding the fabric tissue to the stent being deployed in an idealized straight centerline on the contact stiffness seems to be modest compared the deployed stent without graft.
{"title":"The Impact of a realistic complete Stenting Procedure on the Migration Behaviour: a Numerical Analysis","authors":"Altnji Sam, J. Fayade, B. Bou-Said","doi":"10.35248/2329-6925.20.8.394","DOIUrl":"https://doi.org/10.35248/2329-6925.20.8.394","url":null,"abstract":"The migration of the stent graft is one of the main complications of Endovascular aneurysm repair (EVAR). It is closely related to ineffective contact between the endograft ends and the wall of the blood vessel. In this study, we have developed a realistic stent-graft deployment simulation using the Finite Element Method of 3D nitinol stent in a patient-specific Thoracic Aortic Aneurysm (TAA). This work aims to investigate the impact of the realistic complete stenting procedure by a progressive expanding deployment of the stent graft on the migration behaviour. A comparison of results is investigated between the realistic and non-realistic deployment methods to predict the overall (stent–aorta) biomechanical behaviour. We have also investigated the effect of including the graft material on the mechanical behaviour of the (stent-graft) during the deployment and the contact stability (stentgraft)/aorta after the deployment. The simulation results show that the realistic deployment method did indeed influence the mechanical behaviour, positioning, and eventually the functioning of the stent-graft when compared with the traditional deployment methods. The impact of adding the fabric tissue to the stent being deployed in an idealized straight centerline on the contact stiffness seems to be modest compared the deployed stent without graft.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90357551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2329-6925.19.7.381
Hasan Sumdani, Zanab Shahbuddin, P. Church
Rotational vertebrobasilar insufficiency (RVBI) is a rare form of decreased posterior brain circulation perfusion and can cause symptoms such as dizziness and vertigo. It is typically caused by unilateral dynamic narrowing of the vertebral artery during rotation of the head. Here we present the case of a 70-year-old male who experienced visual disturbances and syncopal episodes with rotation of his head to the left. Investigation was carried out with fluoroscopic imaging, and his symptoms were treated with vascular surgery. Later we discuss the distinctive characteristics of his imaging and his history which includes distorted vascular architecture and past surgery. The etiology of his RVBI has not been seen in the literature before.
{"title":"Rotational Vertebrobasilar Insufficiency Provoked By Distorted Trajectory of Subclavian Artery","authors":"Hasan Sumdani, Zanab Shahbuddin, P. Church","doi":"10.35248/2329-6925.19.7.381","DOIUrl":"https://doi.org/10.35248/2329-6925.19.7.381","url":null,"abstract":"Rotational vertebrobasilar insufficiency (RVBI) is a rare form of decreased posterior brain circulation perfusion and can cause symptoms such as dizziness and vertigo. It is typically caused by unilateral dynamic narrowing of the vertebral artery during rotation of the head. Here we present the case of a 70-year-old male who experienced visual disturbances and syncopal episodes with rotation of his head to the left. Investigation was carried out with fluoroscopic imaging, and his symptoms were treated with vascular surgery. Later we discuss the distinctive characteristics of his imaging and his history which includes distorted vascular architecture and past surgery. The etiology of his RVBI has not been seen in the literature before.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82715299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2329-6925.19.7.380
W. Olszewski
Background: Patients with ischemia of lower limbs not suitable for surgical reconstruction of arteries can be treated with assist by intermittent pneumatic compression devices (IPC). Until recently 1-2 sec hit inflation pumps were used generating emptying veins and arterial-venous pressure gradient enabling greater arterial flow. To obtain better perfusion results we used a pump that, in contradiction to the “empty veins” devices, obstructed limb venous outflow by venous occlusions and in a long period therapy expanded perfusion vessels and brought about persistent reactive hyperemia. Aim: To check toe and calf arterial inflow measured by venous stasis plethysmography and capillary flow velocity during arterial assist IPC in a long-term therapy of ischemic legs. Material and methods: Eighteen patients (12M, 6F) age 62 to 75 with leg peripheral arterial disease (PAD, Fontaine II) were studied. Pneumatic device with two 10 cm wide cuffs (foot, calf) (Bio Compression Systems, Moonachie, NJ, USA) inflated to 120 mmHg for 5-6 sec to occlude the venous flow, deflation time 16 sec, applied for 45-60 min daily for a period of 2 years. Results: Increase in toe arterial pressure, volume, capillary blood flow velocity and one-minute arterial inflow test was observed. The two years therapy showed persistence of resting limb increased toe capillary flow. Intermittent claudication distance increased by 20-120%. After two years assist TBI increased from 0.2 to 0.6 (range 0.3 to 0.8) (p<0.05 vs pre-therapy). Conclusions: The crucial factor of rhythmic repeated venous outflow obstructions should be taken into account in designing effective assist devices.
{"title":"Arterial Assist Intermittent Pneumatic Compression Generating Venous Obstruction with Retrograde Dilatation of Capillaries and Flow Improvement in the Long-Term Therapy of Ischemic Legs","authors":"W. Olszewski","doi":"10.35248/2329-6925.19.7.380","DOIUrl":"https://doi.org/10.35248/2329-6925.19.7.380","url":null,"abstract":"Background: Patients with ischemia of lower limbs not suitable for surgical reconstruction of arteries can be treated with assist by intermittent pneumatic compression devices (IPC). Until recently 1-2 sec hit inflation pumps were used generating emptying veins and arterial-venous pressure gradient enabling greater arterial flow. To obtain better perfusion results we used a pump that, in contradiction to the “empty veins” devices, obstructed limb venous outflow by venous occlusions and in a long period therapy expanded perfusion vessels and brought about persistent reactive hyperemia. Aim: To check toe and calf arterial inflow measured by venous stasis plethysmography and capillary flow velocity during arterial assist IPC in a long-term therapy of ischemic legs. Material and methods: Eighteen patients (12M, 6F) age 62 to 75 with leg peripheral arterial disease (PAD, Fontaine II) were studied. Pneumatic device with two 10 cm wide cuffs (foot, calf) (Bio Compression Systems, Moonachie, NJ, USA) inflated to 120 mmHg for 5-6 sec to occlude the venous flow, deflation time 16 sec, applied for 45-60 min daily for a period of 2 years. Results: Increase in toe arterial pressure, volume, capillary blood flow velocity and one-minute arterial inflow test was observed. The two years therapy showed persistence of resting limb increased toe capillary flow. Intermittent claudication distance increased by 20-120%. After two years assist TBI increased from 0.2 to 0.6 (range 0.3 to 0.8) (p<0.05 vs pre-therapy). Conclusions: The crucial factor of rhythmic repeated venous outflow obstructions should be taken into account in designing effective assist devices.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79868690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2329-6925.19.7.378
Yue Li, Kingsfield Ong MBChB, Faizud Sazzad, Giap Swee Kang Frcs
Acute type A aortic dissection mandates emergent surgical intervention to prevent life-threatening complications and sudden death. Despite the advances in healthcare and medical technology, surgical repair of the dissection is high-risk and associated with significant morbidity and mortality. Aortoesophageal fistula (AEF) is an extremely rare but severe complication of aortic dissection and survivors of this sequalae are sparsely documented in previous literature. We report the successful management of a case with catastrophic perioperative complication of AEF after repair of acute Stanford type A aortic dissection.
{"title":"Life Threatening Aortoesophageal Fistula Following Modified Hemiarch Repair and Aortic Valve Replacement in Acute Type A Aortic Dissection","authors":"Yue Li, Kingsfield Ong MBChB, Faizud Sazzad, Giap Swee Kang Frcs","doi":"10.35248/2329-6925.19.7.378","DOIUrl":"https://doi.org/10.35248/2329-6925.19.7.378","url":null,"abstract":"Acute type A aortic dissection mandates emergent surgical intervention to prevent life-threatening complications and sudden death. Despite the advances in healthcare and medical technology, surgical repair of the dissection is high-risk and associated with significant morbidity and mortality. Aortoesophageal fistula (AEF) is an extremely rare but severe complication of aortic dissection and survivors of this sequalae are sparsely documented in previous literature. We report the successful management of a case with catastrophic perioperative complication of AEF after repair of acute Stanford type A aortic dissection.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89354273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2329-6925.19.7.379
S. M, Sritharan N, Prathap Kumar S, D. I
{"title":"Outcome Analysis Following Iliac Endarterectomy with Ileofemoral Bypass in Patients with TASC C and D Iliac Disease","authors":"S. M, Sritharan N, Prathap Kumar S, D. I","doi":"10.35248/2329-6925.19.7.379","DOIUrl":"https://doi.org/10.35248/2329-6925.19.7.379","url":null,"abstract":"","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81699280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2329-6925.19.7.383
François Caron, A. Garg, E. Kaplovitch, N. Aleksova, Barbara Nowacki, R. deSouza, B. Neupane, Jeffrey S. Ginsberg, J. Hirsh, J. Eikelboom, Sonia S An
Objectives: To determine whether an intermittent mechanical compression device (Venowave) effects walking distance in patients with intermittent claudication as compared to placebo, as well as to review the published literature on the topic. Design: Randomized, cross-over, blinded trial of an intermittent mechanical compression device (Venowave), compared with a sham compression device. Setting: Hamilton Health Sciences, Hamilton, Canada. Participants: 27 patients with severe peripheral limb ischemia, as identified by at least one of: i) ABI<0.4; ii) ACD<200 m (Fontaine stage IIb); iii) toe-brachial index<0.5; or iv) toe pressure<40 mmHg or rest pain due to arterial ischemia. Main Outcome Measures: The primary outcome measure was Absolute Claudication Distance (ACD) while walking on a treadmill. Secondary outcome measures included Initial Claudication Distance (ICD), walk time measured in minutes, and a modified version of the Walking Impairment Questionnaire (WIQ). Results: There was no significant difference in ACD (mean difference: 14.1 m; 95% CI: -31.6 m-59.9 m; p=0.53) or ICD (mean difference: 5.9 m; 95% CI: -26.3 m-14.5 m; p=0.55) between active and sham devices. Mean walk time was identical between active and sham devices (5.6 minutes (2.1) vs. 5.6 minutes (2.0); p=0.99). The modified WIQ score was higher in the active group compared with the sham group (mean difference 2.1 m; 95% CI: 0.3 m-3.9 m; p=0.03). Conclusion: In patients with moderate to severe intermittent claudication, the Venowave device did not increase walking distance when used immediately prior to and during measured effort. This is the first study to use a sham device as a comparator in this specific context.
{"title":"Venous Return Assist Devices for Intermittent Claudication: A Randomized Controlled Trial Utilizing a Sham Comparator","authors":"François Caron, A. Garg, E. Kaplovitch, N. Aleksova, Barbara Nowacki, R. deSouza, B. Neupane, Jeffrey S. Ginsberg, J. Hirsh, J. Eikelboom, Sonia S An","doi":"10.35248/2329-6925.19.7.383","DOIUrl":"https://doi.org/10.35248/2329-6925.19.7.383","url":null,"abstract":"Objectives: To determine whether an intermittent mechanical compression device (Venowave) effects walking distance in patients with intermittent claudication as compared to placebo, as well as to review the published literature on the topic. Design: Randomized, cross-over, blinded trial of an intermittent mechanical compression device (Venowave), compared with a sham compression device. Setting: Hamilton Health Sciences, Hamilton, Canada. Participants: 27 patients with severe peripheral limb ischemia, as identified by at least one of: i) ABI<0.4; ii) ACD<200 m (Fontaine stage IIb); iii) toe-brachial index<0.5; or iv) toe pressure<40 mmHg or rest pain due to arterial ischemia. Main Outcome Measures: The primary outcome measure was Absolute Claudication Distance (ACD) while walking on a treadmill. Secondary outcome measures included Initial Claudication Distance (ICD), walk time measured in minutes, and a modified version of the Walking Impairment Questionnaire (WIQ). Results: There was no significant difference in ACD (mean difference: 14.1 m; 95% CI: -31.6 m-59.9 m; p=0.53) or ICD (mean difference: 5.9 m; 95% CI: -26.3 m-14.5 m; p=0.55) between active and sham devices. Mean walk time was identical between active and sham devices (5.6 minutes (2.1) vs. 5.6 minutes (2.0); p=0.99). The modified WIQ score was higher in the active group compared with the sham group (mean difference 2.1 m; 95% CI: 0.3 m-3.9 m; p=0.03). Conclusion: In patients with moderate to severe intermittent claudication, the Venowave device did not increase walking distance when used immediately prior to and during measured effort. This is the first study to use a sham device as a comparator in this specific context.","PeriodicalId":17397,"journal":{"name":"Journal of Vascular Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85768494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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